Design and methods of a community supported agriculture program with native Americans: the go healthy study

Native Americans (NAs) experience significant disparities in diet-related conditions, including obesity, hypertension, and diabetes. Many NA communities are food insecure and lack access to fresh fruits and vegetables. While public health interventions have focused primarily on behavioral change, these strategies are limited without structural changes to the local food system. The Go Healthy Study is a community-based participatory research study using an innovative, multilevel community supported agriculture intervention to improve diet and reduce chronic disease risk factors among NA adults. This 16-week, randomized, wait-list controlled trial includes the following components: 1) a weekly box of fresh produce; 2) a healthy eating and traditional foods curriculum with recipes incorporating the produce; 3) NA traditional foods cooking demonstration videos; and 4) a kitchen “starter kit” with basic cooking equipment. Eligible participants include NA adults residing within the Osage Nation with a body mass index (BMI) ≥ 25 kg/m2. We expect approximately 400 adults to participate in the Go Healthy Study. Data are collected at baseline and follow-up upon completion of the intervention. The primary outcomes are to improve systolic blood pressure and low-density lipoprotein cholesterol and increase fruit and vegetable intake. Secondary outcomes include BMI, hemoglobin A1c, food security, and health status. This manuscript describes the study rationale, design, intervention components, timeline, and measures.